Part II of our injury series: Do some injuries become more common later in the NFL season? And has the NFL succeeded in cutting down on concussions?
08 Sep 2004
interviewed by Aaron Schatz
Since Will Carroll began writing about baseball injuries, the word "medhead" has been added to the sports fan lexicon next to the word "stathead." Carroll writes the daily Under the Knife column for Baseball Prospectus, as well as hosting the weekly syndicated program Baseball Prospectus Radio, and is the author of the book Saving the Pitcher. After appearing on BP Radio last week (archived mp3 to be available shortly, we hope) I asked him to extend his medical knowledge from the diamond to the gridiron.
Football Outsiders: Let's start with the labrum, a subject you have written about extensively. It shatters the careers of pitchers. Yet Rich Gannon says he feels "better than ever." Do you think the labrum injury is going to effect him, and if the effect is small or nonexistent why does the torn labrum ruin throwing a baseball but not a football?
Carroll: The difference is in the mechanics. The football throw is not the same mechanical beast we see in the baseball throw. The mechanics are much more reliant on hip turn and arm extension -- which oddly sounds like Tom House. Granted, Tom also coached QBs for a long time, so it's not completely dissimilar. Using good football mechanics, the humeral head doesn't rotate as much, keeping the labrum from involvement. I'd also guess that most QBs are stronger through the shoulder girdle than most baseball pitchers.
Football Outsiders: Roosevelt Colvin is attempting to come back from a broken hip, an injury very similar to the one that ended Bo Jackson's football career. What is the outlook for recovery from this injury? Will he be productive this season? Will he ever be as good as he was before the injury? How has medicine changed in a decade so that Colvin, unlike Jackson, can play football again?
Carroll: Remember, it has been more than a decade since Bo's injury. Technology and medical science are way better. Colvin's injury is more analogous to Mark Mulder's injury than Bo Jackson's. Bo had the complication of avascular necrosis (the bone literally died) and had to be replaced. Colvin is simply recovering from a fracture. Those, we know, heal on a predictable schedule and can be helped by new techniques and medicines. I don't know what was done with Colvin, but there's no reason to think his hip is not sound nor any more likely to be broken than any other. I'm unsure if he'll be what he was, simply due to the difficulty in assessing this in isolation, but it wouldn't surprise me, especially in that system.
Football Outsiders: DeAngelo Hall, the Falcons' #1 draft pick, also fractured his hip in the preseason, although from what I read it is a less severe fracture. How does a fracture like Hall's differ from a fracture like Colvin's? Is the Atlanta prediction of 6-10 weeks accurate?
Carroll: Hall's fracture is small and non-articular. It's simple carpentry at this point -- small cracks are easier to fix than big. They take less structural integrity, less healing, and affect other structures less. I'd lean towards the latter of that prediction, but this is a frontier injury -- we don't have much data.
Football Outsiders: Anquan Boldin tore his meniscus. What is this injury? The Cardinals say he'll be back in 8-12 weeks. Is that realistic, and will he be limited if he does return this season?
Carroll: The meniscus is the cartilage that serves as the cushion between the femur and tibia. Located behind the knee, this is the "torn cartilage" that everyone hears about. It was a significant tear and part of the meniscus was removed. What I can't tell is if Boldin had an arthroscopic procedure or an open procedure. The language I could find was confusing, but leaned to the open. With that, I'd definitely lean to the late portion, if then. A scope "scrape and tape" puts someone out about a month in football. He should be fine once he returns.
Football Outsiders: Correll Buckhalter and David Boston both tore their patellar tendons this preseason. Can you tell us a little about that injury, what the recovery is like, and whether we should expect these players to return at full strength in 2005, or partial strength, or is there a chance they won't be back at all?
Carroll: The patellar tendon is the band that you can feel above and below the kneecap. It's an important structure connecting muscle to bone. These injuries normally happen when the muscle is so strong it tears the bone from its attachment or when a player stops so suddenly that the bone cannot be decelerated. It was much more common on turf -- I can't remember the player's name, but I think it was in Philly where a WR jump-stopped and tore both knees apart. Ouch! I worry more about Boston with his, ummm, muscled physique. There's some connection between patellar tendon injuries and steroids. Knee injuries tend to take two years to recover from. We saw this illustrated clearly with Edgerrin James. One year to play, two years to be "back."
Football Outsiders: This is Buckhalter's second season lost to injury. In BP you write a lot about the idea of "health as a skill," in regards to players who get injured a lot like Chris Snelling. In my fantasy league we used to joke that Erubiel Durazo was Spanish for "Fred Taylor." But Taylor has now played two full seasons after missing parts of his first four years. If health is a skill, is it possible to improve that skill and go from injury-prone to relatively healthy, or should we still be waiting for the inevitable injury to guys like Taylor who have missed so much time in the past?
Carroll: Sure, it's possible. It's more possible in football because of the nature of the sport. In baseball, most injuries are overuse. In football, most injuries are traumatic. Traumatic injuries are simply wrong place, wrong time. A running back gets his knee cut out from under him. A QB gets blindsided and hurts a shoulder. A wide receiver steps on a seam and blows out an ankle. There's no skill to these, but when we see the same injury over and over, we have to consider if the structure is unsound. Mark Schlereth's knees were chronic. You know what you have in that situation. With Taylor, he just seems unlucky and I guess that can turn around as quickly as it came.